术后早期肺栓塞溶栓治疗10例报告.pdf

Med J Chin PLA, Vol. 37, No. 12, December 1, 2012 　1139 术后早期肺栓塞溶栓治疗10例报告 朱雄龙，韩文斌，郑涛，朱世宏，孙金勇 [摘要]　 目的　探讨术后早期急性肺栓塞溶栓治疗的可行性，以及溶栓药物、剂量和给药模式的选择。方法　 对北京军区总医院重症医学科1999年5月－20 11年7月收治的10例术后早期急性肺栓塞患者溶栓治疗的临床资料进行回 顾性分析，并复习国内外相关文献，总结临床诊治经验。结果　10例急性肺栓塞均诊断明确，一经诊断立即早期进 行溶栓治疗，其中7例经中心静脉溶栓，2例经外周静脉溶栓，1例采用介入碎栓溶栓治疗，全部有效，起效时间最快 30min ，氧合改善最慢为12h 。9例治愈，5例患者有一过性局部出血，1例死于感染并发症。结论　术后早期有选择地 对某些急性肺栓塞患者进行溶栓治疗是安全、可行、有效的。 [关键词]　手术期间；肺栓塞；溶栓 [中图分类号]　R563.5 [文献标志码]　A [文章编号]　0577-7402 (20 12) 12- 1139-03 Thrombolytic therapy for early postoperative pulmonary embolism: a report of ten cases * ZHU Xiong-long, HAN Wen-bin , ZHENG Tao, ZHU Shi-hong, SUN Jin-yong Intensive Care Division, General Hospital of Beijing Command, Beijing 100700, China * Corresponding author, E-mail: beizonghanwenbin@163.com [Abstract]　Objective　To inv estigate th e feasibility of thromb oly tic th erapy for early p ostop erativ e pulmonary emb olism, and th e ch oice of thromb oly tic drug, and its dosage and administration route. Methods　A retrosp ectiv e analy sis of th e clinical data of 10 patients w ith early acute pulmonary emb olism undergoing thromb oly tic th erapy in our department from 1999 to 20 11 w as p erformed, foll ow ed by a rev iew of related literature in China and abroad, th e ex p erience of th e diagnosis and treatment w ere summarized. Results　Th e diagnosis of 10 cases of acute pulmonary emb olism w ere doubtl ess. A fter diagnosis, immediate early thromb oly tic th erapy w as giv en, including 7 cases of central v enous thromb oly sis, 2 cases of p eriph eral intrav enous thromb oly sis, and 1 case w ith interv enti onal thromb ectomy plus thromb oly ti c th erapy. Th e treatm ent w as su ccessful in all th e p ati ents, w ith